5Cities Homeless Coalition
Helping Hands Fund Overview
In partnership with the South County Youth Coalition, the 5Cities Homeless Coalition has developed a
Helping Hands Fund to assist homeless neighbors address a wide variety of immediate needs.
PROGRAM FOCUS
The purpose of this program is to provide limited assistance (usually one-time) that will help individuals
and families move towards self-sufficiency. We seek to help families and individuals in need in the Five
Cities area with limited funds to address their immediate needs, and move them toward self-sufficiency.
While homelessness is not a prerequisite to receive these funds, it is our intent to help those most in
need who are homeless or facing poverty. The funds are provided through a grant from the San Luis
Obispo County Community Foundation.
Statement of Need - To achieve the goal of moving toward self-sufficiency, the funding request must
be for a specific purpose and there must be a clear statement of how this grant will help them move
forward. We are especially interested in helping with work related needs and retaining or obtaining
housing.
Last Dollars In – Funds available through this program should be the last dollars needed to address an
issue. These funds are not intended to supplant existing forms of support, but rather to augment other
funding, or be used as a last resort when no other funding is available.
Up To $250 Per Individual – It is our hope to limit funding requests to $100 or less, however should
the need arise whereby more funds are needed, the maximum available is $250 per individual.
Case Management or Follow-up - The client must agree to receive case management services or to a
follow-up contact to ensure the funds are to be used as requested. A client goal will be mutually set as
a benchmark for evaluation. There will be at least one follow-up contact between two weeks and six
months to evaluate whether the grant actually helped the beneficiary achieve their goal within the
agreed upon time. The case management or follow-up process will be determined on a case by case
basis with the referring agency.
No Direct Assistance – These funds can be used to pay for bills, or for good or services. No funds will
be given directly to the beneficiary.
By Referral Only – These funds are available only by referral by an area service provider (non-profit
agency, church or government agency) in partnership with the 5Cities Homeless Coalition. These
partner providers will be responsible for determining the need and whether the individual or family
meets the program criteria.
Limited Support Only – These funds are available limited basis only per individual. Funds will only be
given one-time, unless a subsequent request is made to address the same goal as stated previously.
5Cities Homeless Coalition
www.5chc.org
(805) 710-4330
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APPLICATION PROCESS
A representative of the referring agency or service provider is charged with completing the Helping
Hands Request for Funds form.

Organization Requesting Funds – List the name of the organization requesting the funds,
including an organization contact name and contact phone number.

Name of the Client – Please provide the name of the client and a contact phone number for
them. Additionally please note whether the client is homeless or not. As a condition of the
grant, all client names will be tracked, ensuring that grants from this fund are provided on a
one-time basis only per household.

Funds requested – Please detail the amount of funds you are requesting, and for what
purpose. Please note what date the funds will be needed, if this isi the total It will be
important to know by what date the funds are needed, and if this is the total amount needed,
or if additional sources are also contributing.

Make Check Payable – Please note to whom the check should be made payable. Funds
from this grant cannot be given to the individual client, but rather need to be made payable
to a business for services.

Email Form – The 5Cities Homeless Coalition is responsible for processing the request,
gaining approval from the South County Youth Coalition and ensuring coordination of the
payment. You may email the form to [email protected] (preferred). Forms can also be
mailed to P.O. Box 558, Grover Beach, CA 93483 or you can arrange to drop them off at the
5CHC Administrative Office. Office hours vary, so please call 710-4330 to make
arrangements.

Payment – Arrangement for payment will be coordinated by the 5Cities Homeless Coalition.

Questions – You may contact Liz Howland at the 5Cities Homeless Coalition with any
questions regarding this program, [email protected] or (805) 710-4330.
5Cities Homeless Coalition
www.5chc.org
(805) 710-4330
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5Cities Homeless Coalition - South County Youth Coalition
Date: _____________________
Organization Contact Phone: _________________
Organization Requesting Funds:____________________________________________
Contact Person: _______________________________________________________
Name of Client you are requesting funds for: _________________________________
Client Phone: __________________
Date money is needed by: _______________
I am requesting $__________________ for________________________________
__________________________________________________________________
__________________________________________________________________
IS THE CLIENT/FAMILY HOMELESS _____
Has this client/family received funds from the Helping Hands grant in the past? If so, how
much were they awarded and for what purpose?
__________________________________________________________________
Who should check be made out to? _______________________________________
For SCYC office use only:
Request: _____Approved ____Denied
Date: ____________Check #________Amount__________
Name of Case Manager: __________________
Site: ____________________
Client Goal:_________________________________________________________
__________________________________________________________________
__________________________________________________________________
Was Client able to reach their goal by closing date? Yes / No
Initial Date of Contact
_ _/_ _/_ _
Notes:
5Cities Homeless Coalition
Follow up at 3 Months
Yes / No
Follow up at 6 Months
Yes / No
Notes:
Notes:
www.5chc.org
Follow up at 12 Months
Yes / No
Notes:
(805) 710-4330
Closing Date
_ _/_ _/_ _
Notes:
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